Complete remission in a patient with widely metastatic HER2-amplified pancreatic adenocarcinoma following multimodal therapy informed by tumor sequencing and organoid profiling
King, D. A.; Smith, A. R.; Pineda, G.; Nakano, M.; Michelini, F.; Goedegebuure, S. P.; Thyparambil, S.; McCormick, A.; Ju, J.; Cioffi, M.; Griffith, M.; Grandori, C.; Pollastro, M.; Rosati, R.; Margossian, A.; Chatterjee, P.; Ainge, T.; Flory, M.; Ocampo, P.; Chen, L.-m.; Poultsides, G. A.; Baron, A. D.; Chang, D. T.; Herman, J. M.; Gillanders, W. E.; Park, H.; Hoos, W. A.; Nichols, M.; Fisher, G. A.; Kuo, C. J.
Show abstract
Here, we demonstrate a complete clinical response achieved in a patient with HER2+ metastatic pancreatic ductal adenocarcinoma to a coordinated barrage of anti-HER2, personalized vaccine and checkpoint inhibition immunotherapy, radiation, and chemotherapy. Comprehensive organoid profiling with drug sensitivity screening and drug testing suggested a vulnerability to anti-HER2 directed therapy, facilitating personalized treatment selection for our patient, which contributed to her clinical benefit. Immune response monitoring following personalized vaccine, radiation and checkpoint inhibition showed a sustained increase in neoantigen specific T cell response.
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